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Septische shock

Dutch -ErasmusMC - week 4.4.1- ZO3

Wanneer is er srpake v SIRS? (Systemic inflammatory response syndrom) -temperatuur >38C of <36C -hartfreq. >90/min -ademfreq. >20/min of mechanische beademing -witte bloedcellen >12 of <4*10.9/l of >10% immaturen
Definitie van sepsis SIRS+ bewezen of verwacht infectieus proces
Definitie v severe sepsis sepsis+ 1 acute orgaandisfunctie -longen,nieren, stolling, CZS, metabole acidose, cardiovasculair
Definitie v septische shock severe sepsis + hypotensie ondanks adequate vochttoediening en vasopressors
DD patient met hevige buikpijn en shock -acute cholecystitis -acute ernstige pancreatitis -perforatie v maag of duodenum -mesenteriaal trombose -miltinfarcering
Hoe bereik je debeste prognose bij shock ? Door vroeg en adequaat herstel v/d circulatie en O2-transport.
Noem 2 nieuwe ontwikkleing in de behandeling v sepsis en septische shock -antisepsis middel: recombinant geactiveerd proteine C -Strikte glucose regulatie en behandeling v/e relatieve/ absolute bijnierschorsinsufficientie verbeteren de prognose sterk
Created by: SavageMD